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Objective To analyze the long term efficacy of sodium hyaluronate on the treatment of moderate knee osteoarthritis. Methods From January 2015 to December2016 year in our hospital , 84 patients with moderate knee osteoarthritis were participated in the study, and were randomly divided into two groups, 42 cases in each group. The control group were given oral glucosamine sulfate . Based on the treatment of the control group, the observation group were received sodium hyaluronate . The long-term effect in the two groups were compared. Results The excellent rate of knee joint function recovery was 80.95% in the observation group, and 54.76% in the control group, the difference in the two groups had statistically significant, P<0.05; Three months, nine months, and one years after treatment, the knee joint function Lysholm scores in the observation group were significantly higher than those in the control group; Three months, nine months, and one years after treatment, AIMS quality of life score in the observation group was significantly lower than those in the control group. Conclusion The long-term effect of sodium hyaluronate in the treatment of moderate knee osteoarthritis is obvious. It can help the knee joint function to be improved significantly, and promote the quality of life of patients significantly improved. It is worth to be widely applied.
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The development of proteomic technique has sparked new focus on novel protein markers for many diseases including cancer. Urine is one of the most useful biofluids for routine testing to provide an ideal resource for the discovery of novel biomarkers, with the advantage over tissue biopsy samples due to the ease and the less invasive nature of urinary collection. This review summarizes urinary protein tumor markers found in prostate cancer, bladder cancer, lung cancer and breast cancer that have shown potential for urogenital and non-urogenital cancer, so as to provide reference on high sensitive and high specific urinary protein tumor markers for early prevention, early diagnosis and treatment of cancer.
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Objective To detect the levels of procalcitonin,blood routine,C-reactive protein of children with bronchopneumonia,to analyze the clinical value combined with the age and to provide the experimental basis for clinical diagnosis and treatment.Methods 100 children with bronchial pneumonia were selected.According to admission number,they were randomly divided into the study group and the control group,50 cases in each group.The control group received routine diagnosis and treatment.The study group was deteced blood calcitonin,blood routine,C-reactive protein level and diagnosed and treated combined with the age.The clinical curative effect,recovery time were observed.The referral rate,children fever,cough,X-ray pulmonary inflammation disappeared time,the average recovery time,and medical expenses were assessed and recorded.Results The cure rate of the study group was 80.0%(40/50),which was higher than 66.6%(33/50) of the control group,the referral rate of the study group was 6.0%(3/50),which was lower than 22.0%(11/50) of the control group,the differences were statistically significant (χ2 =8.61,8.95,all P<0.05).The medical expense of the study group was (3 273.15 ±260.35)yuan,which was lower than (5 426.42 ±238.20)yuan of the control group,the difference was statistically significant (t=11.47,P<0.05).The average recovery time of the fever,cough,X-ray pulmonary inflammation in the study group were (3.29 ± 0.48)d,(5.36 ±0.63) d,(4.17 ±0.57) d,(6.48 ±0.86) d,which were shorter than those of the control group [(4.51 ±0.41)d,(6.70 ±0.52)d,(5.84 ±0.61)d,(7.79 ±0.93)d],the differences were statistically significant (t=8.50,8.69,8.27,9.04,all P<0.05).Conclusion In basic hospitals,detection blood PCT,blood levels of C-reactive protein of children with bronchial pneumonia and combined with the age for diagnosis and treatment, the clinical curative effect is better, the improvement time of the clinical signs or symptoms is shortened, referral rate decreased,medical costs declined.It is worth popularization and application in the basic level hospital.
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Objective: To evaluate the effect of echocardiography for occluding the multiple seconded atria1 septal defects ( MASD) in relevant patients. Methods: A total of 42 MASD patients were selected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The transcatheter closure was monitored by TTE and X-ray, the effect of treatment was evaluated by TTE, ECG and chest X-ray at 24 hours and 1, 3, 6 months after the procedure. There were 38 patients with 2 defects, 3 with many central small defects and 1 with 3 defects. The patients included 17 male and 25 female with the mean age of (32.6 ± 13.4) years. Results: The size and distance of the defects were measured with 4 cardiac chambers cross sectional study. The mean diameter of bigger defect from up to down was (9-27) mm, with the mean of (20.7 ± 6.1) mm, from front to back was (8-23) mm, with the mean of (16.9 ± 5.7) mm;the mean diameter of small defect from up to down was (3-12) mm, with the mean of (6.8 ± 3.6) mm. The length of the defect interva1 was (4-18) mm, with the mean of (7.9 ± 2.6) mm. There were 4 patients with 2 defect interval at 8.7 mm who received 2 occluders without post-operative lfow shunt. The rest 38 patients received 1 Amplatzer occluder which was (14-36) mm with the mean of (25.1 ± 6.4) mm which was (6.9 ± 1.7) mm larger than echocardiographic prediction. The success rate of implantation was 100%. There were 17 (40.5%) patients with post-operative lfow shunt. The patients were followed-up for (6-36) months, with the mean of 18.7 months, there were 11 (26.2%) patients with small amount of lfow shunt at 3 months after the operation. Conclusion: Echocardiography is important for choosing the type and size of occluder devices, in-operative monitoring and post-operative effect evaluation for treating the ASD patients.
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ObjectiveTo evaluate the risk factors for sentinel lymph node(SLN)metastasis,and assess the value of the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in predicting SLN metastasis in breast cancer patients.Methods A sentinel lymph node biopsy(SLNB) database containing 1227 consecutive breast cancer patients(412 patients with a positive SLN)was retrospectively analyzed.The value of MSKCC nomogram was predicted by drawing the trend line and calculating the area under the curve(AUC) of receiver-operator characteristic(ROC). Meanwhile,the risk factors of SLN metastasis were evaluated. Results Tumor size,tumor location,histological grade,lymphovascular invasion,mulifocality,ER and PR status were correlated with SLN metastasis( all P ＜ 0.05 ).All the above factors but tumor location were significant independent predictors for SLN metastasis(all P ＜ 0.01 ).The MSKCC nomogram presented AUC value of 0.730 for ROC.Patients with predictive values lower than 16％ had the frequency of 0.9％ for SLN metastasis while patients with predictive values higher than 70％ had the frequency of 96.2％.ConclusionsThe risk factors of SLN metastasis in our study are consistent with those in MSKCC nomogram.MSKCC nomogram is a useful tool in predicting the probability of SLN metastasis for breast cancer patients.Axillary surgery can be avoided in patients with the predictive values lower than 16％,axillary lymph node dissection could be done in patients with the predictive values higher than 70％,and other patients should still undergo SLNB.
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Objective To discuss the morphological features and diagnosis of congenial double orifice mitral valve (DOMV) deformity by echocardiography.Methods Twenty consecutive patients were examined.The changes of the morphology and flow dynamics of DOMV were studied,and other congenital cardiac abnormalities were also observed.These results were compared with those of surgery.Results Thirteen cases of adult patients were all with significant hemodynamic abnormalities,and underwent mitral replacement.One case of school child with muscular ventricular septal defect underwent mitral replacement because of obvious hemodynamic changes.Six cases were under 2 years old,2 cases with complete endocardial cushion defect accompanied with pulmonary hypertension,1 case with partial endocardial cushion defect accompanied with coarctation of the aorta underwent corrective operation.No significant hemodynamic abnormalities in 2 cases,1 case was associated with coarctation of the aorta and patent ductus arteriosus,the other patient with membranous ventricular septal defect.Severe stenosis in 1 case with papillary muscle dysplasia,because there was no suitable operation and take conservative therapy.Seventeen cases were confirmed by the results of open-heart surgery.Conclusions Echocardiography can provide an accurate method to diagnose DOMV and evaluate the hemodynamic changes.
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Objective To evaluate the results of hybrid procedure in treating infants and children with severe pulmonary stenosis (PS) and the clinic value of echocardiography in the whole procedure.Methods Hybrid therapy was performed in 43 patients [(7.1±6.8)months,ranging 5 days to 33 months] with severe PS.The echocardiography data in the whole procedure and follow up were reviewed.Results Aided by echocardiography,the hybrid therapy was successful in 43 cases without major complication.Immediately following valvuloplasty,the gradient across pulmonary valve decreased from (92.5±21.4)mm Hg to (23.6±13.0)mm Hg (P<0.05).The growth and development of 27 patients in follow-up study was well.No restenosis was found and tricuspid regurgitation decreased differently.Conclusions Hybrid procedure is effective and safe for the treatment of infants and children with severe PS.And echocardiography play an important role in the whole procedure.
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ObjectiveTo identify the suitable echocardiographic predictor of speckle tracking imaging (STI) for evaluation of development of left ventricle(LV) after pulmonary artery banding (PAB).Methods Seven children older than 3 months with transposition of great arteries with intact ventricular septum (TGA) were enrolled,they received pulmonary artery banding (PAB group).Eight body surface area matched healthy children were severed as control group.Using the STI technique,the rotation curves at apex and base were analyzed.ResultsAll the patients discharged eventually.The intraoperative LV/RV systolic pressure ratio in PAB group was (0.32 ± 0.04):1.There were no differences in ejection fraction and wall thickness between control and PAB group.However,the end diastolic diameter and end diastolic volume in PAB group was significantly reduced.Compared with the control group,the hypoplasia of LV in PAB group was associated with an extended time to peak basal rotation,and furthermore,the basal and global torsion was significantly reduced by 3 times.ConclusionsSTI showed local rotation and global torsion might be thevaluable predictor to evaluate the regressed and the development of LV peri-PAB procedure for the older children with TGA.
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Objective Endothelin is a key role in the pathogenic of pulmonary arterial hypertension. High concentrations of endothelin-1 have been recorded in plasma and lungs of patients with pulmonary artery hypertension associated with congenital heart disease, and the concentrations of endothelin-1 was correlated with severity degree of pulmonary arterial disease.Endothelin exerting vasoconstrictor and mitogenic effects by binding to two distinct receptor isoforms in the pulmonary vascular smooth muscle cells: endothelin A and B receptors. Bosentan is an orally active dual ( A and B) endothelin receptor antagonist that has been shown to improve exercise capacity, haemodynamics, and clinical worsening in many clinical trials, but have no experience in post-operation of congenital heart disease with PAH. In our country, there are lots of elder patients of congenital heart disease accompany with pulmonary arterial hypertension. And they have poor prognosis after operation because pulmonary arterial hypertension leads to right ventricular failure and sudden death. So we hope bosentan can improve clinical outcome of these patients. This time we present the results of the bosentan trial in post-operative patients still with pulmonary arterial hypertension, a randomized controlled trial designed to assess the efficacy and safety of the dual endothelin receptor antagonist bosentan in post-operative pulmonary arterial hypertension, and present the first experience of bosentan for these patients.Methods This study was a prospective clinical trial. The objects were 30 patients ( age:4 months - 6.8years,weight:5 - 15 kg) who still had pulmonary artery hypertension at one week after cardiac defects repaired. They were randomized to controlled ( n = 15 ) or to bosentan ( n = 15 ). Dosage regimen: 10 - 20 kg patients, 31. 25 mg qd ( 4 weeks ) ,31.25 mg bid ( 8 weeks);5 - 10 kg patients, 15.6 mg qd ( 4 weeks), 15.6 mg bid ( 8 weeks). Evaluate the efficacy and safety of Bosentan through the amelioration of pulmonary arterial systolic pressure, WHO functional class, and clinical worsening. Results We monitored pulmonary arterial systolic pressure after operation by echocardiogram 2 times, baseline ( 1 week after operation) and at 12 weeks later. The pulmonary arterial systolic pressure decreased 19.5 mm Hg in Bosentan group( P =0. 000), and decreased 10.3 mm Hg in control group(P =0. 164), with the mean treatment effect of 9.2 mm Hg (P=0.049,95%CI:0. 1 -18.3). The effct of bosentan on haemodynamics is also reflected in the reduction plasma ET-1 concentration in bosentan group. Plasma ET-1 in control group increased (0. 15 ±0.1 )fmol/ml(P =0.77), however, decreased (2.01 ±0.3)fmol/ml (P=0. 03) in bosentan group; Bosentan prevented post-operation PAH. Bosentan treatment was associated with lower incidence of worsening NYHA functional class compared with controlled(0 in the bosentan group vs 13% in the placebo group) There was a delay in time to clinical worsening with bosentan compared wih controlled group. Abnormal liver function occurred in 2 cases in bosentan group but resolved after discontinuation of bosentan treatment, no other side effects. Bosentan produced hemodynamic improvement and was well tolerated in infant. Conclusion Bosentan administration in patients with postoperative PAH is safe and efficient. Bosentan is a new effective approach to therapy for postoperative pulmonary arterial hypertension in children.
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Objective The aim of this report was to study the early and mid-term outcome in hospital and follow-up mortality, predictors for late pulmonary stenosis (PAS) and insufficiency of neo-aortic valve (neo-AVI) in patients with transposition of great arteries (TGA) and Taussig-Bing malformation undergoing arterial switch operation ( ASO ). Methods Between January 2004 and December 2007, 169 patients (129 male, 40 female; mean age of [(11.71 ± 26.3 ) months] with TGA or Taussig-Bing malformation underwent ASO. The patients were divided into Group Ⅰ (n = 56 ): TGA with intact ventricular septum and Group Ⅱ ( n = 113 ): TGA with ventricular septal defect (VSD). All patients were followed up in out-patient department by ultrasonic cardiogram. The mean follow-up periods was (27.66 ± 14.6 ) months. Multiple logistic regression analysis was performed to find out the risk factors. Results The overall hospital mortality was 11.24% (19/169)and there was no significant difference between the two Groups. With the improving of perioperative management, the hospital mortality decreased from 16.67% in 2004 to 3.92% in 2007. The overall actuarial survival at 1-, 3- and 5-year follow-up was 94.00%,91.33%, and 91.33%, respectively. The multivariate analysis revealed that age above 6 months was a strong predictor for poor postoperative survival. Predictors for neo-AVI were: combined with VSD, age > 6 months and postoperative neo-AVI Z-score > 1. Predictors for moderate to severe PAS were age ＜ 1 months and pulmonary artery plasty with an unstretchable patch. Conclusion ASO remains the optimal choice for treating various forms of TGA with an acceptable early and mid-term outcome regarding overall survival rate. Patients with TGA should be treated as early as possible. Age >6 months is a predictor for poor postoperative survival and neo-AVI. Mismatch between the neo-aortic root and distal aorta may induce neo-AVI. Unstretchable patch in pulmonary artery plasty may induce PAS.
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0bjective To summarize the experience of postoperative and mid-term echocardiographic evaluation of modified Blalock-Tasussig(BT)shunts. Methods During 2003-2006,thirty five consecutive patients received modified BT shunts and survived postoperative 6 months were enrolled in this study.Transthoracic echocardiography was utilized to evaluate the patency of shunts and the change of pulmonaryarteries(PA)and left ventricle(LV). Results Three patients received the emergence surgery for the intervention for the BT shunts. The follow-up was (21.2±11.3) months. During the follow up,the obstruction of shunts occurred in 7 cases. After the placement of shunts,the mean size of PA increased by 31.2%,meanwhile,the size of LV increased by 25.6%. Nineteen patients received the followed definitive repair or palliative operations. Compared with the patients still waiting for the growth of PA,the patients who receiving the second staged procedure achieved the more appropriate PA growth. Furthermore,for the above patients,there was no significant difference between the angiographic and echocardiographic evaluation for the PA size. Conclusions Echocardiography could accurately diagnose the patency of shunts and record the growth of PA and LV following BT shunts. Echocardiography is a highly reliable noninvasive approach for the perioperative evaluation and mid-term follow-up for the modified BT shunts.
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In this study, we demonstrated that immobilized fibronectin (FN) enhanced LAK activity, and that the enhanced LAK activity was completely abrogated by an anti-VLA-5 monoclonal antibody and RGD peptide. Fresh -spleen cells expressed VLA-4, VLA-6 and vitronectin receptor, whereas VLA-5 was expressed only on the spleen cells activated with IL-2. LAK cells showed increased adhesion to immobilized FN compared with that to control BSA, and the increased adhesion of LAK cells to immobilized FN was inhibited by anti-VLA-5 monoclonal antibody. Conjugate-formation assay showed that the LAK cells cultured on immobilized FN bound to target cells more efficiently than the control LAK cells, and that anti-LFA-1 monoclonal antibody inhibited the LAK-target cell binding. Immobilized type IV collagen and laminin, as well as FN, enhanced LAK activity. All these results suggest that the interaction of inte-grins expressed on LAK cells with extracellular matrix proteins act as co-stimulator for the enhancement of LAK activity , and that anchorage is necessary for full activation of LAK cells.
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Objective To explore the findings and clinical value of bedside ultrasonography in superior vena cava(SVC) syndrome in children after cardiac operations for congenital heart disease. Methods Bedside ultrasonography was performed on 6 children suspected of SVC syndrome after 5-38 hours[(22?11) hours] postoperatively,to view the structure and blood flow of SVC and its main branches. All the patients were reoperated as soon as diagnosed. Results Five children got severe SVC obstruction, marked with stenosis, turbulent, continuous and high velocity in SVC. Color Doppler flow imaging presented almost absence of flow due to nearly complete occlusion of the innominate vein in 1 child. Ultrasonographic diagnosis was confirmed by the reoperative findings. All the patients were cured by reoperation and discharged with normal ultrasonographic results. Conclusions Bedside ultrasonography can provide early and accurate diagnosis in children with SVC syndrome after cardiac operation.
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Objective: To determine tetrahydropalmatine in Juyanbaokang Granules (Rhizoma Corydalis, Radix Aconcti Lateralis Preparata, Radix Rauwolfiae, etc.) by SPE-HPLC. Methods : Samples were purified by C 18 SPE column. HPLC column was Dikma Diamonsil C 18 (250mm?4.6mm,5?m), mobile phase was 0.05M potassium dihydrogen phosphate-0.005M sodium heptanesulfonate-acetonitrile (1.2∶1.2∶1), flow rate was 1.2 mL?min -1 and detection wavelength was 230nm. Results : The calibration curve was linear in the range of 0.067 ～0.402?g for tetrahydropalmatine ( r =0.9997). The average recovery was 98.66%. Conclusion : The method with good separation is convenient, rapid, accurate and reliable.